title: A case of mass-forming splenic tuberculosis: MRI findings with emphasis of diffusion-weighted imaging characteristics.
abstract: Tuberculosis remains one of the most prevalent and fatal infectious diseases in spite of considerable improvements in medical science. The diagnosis and treatment of extrapulmonary tuberculosis involving the abdomen is still complicated owing to vague or non-specific clinical features. Although rare, isolated splenic involvement is one of the important manifestations of extrapulmonary tuberculosis, and imaging suspicion of the disease is essential. We report a case of surgically confirmed mass-forming splenic tuberculosis showing a layered pattern consisting of caseous necrosis with profound restriction of water molecules surrounded by an irregular rind of granulation tissue with less diffusion restriction on diffusion-weighted magnetic resonance imaging (DWI). In the differential diagnosis of neoplastic or non-neoplastic mass-forming lesions involving the spleen, this unique DWI feature could be helpful in characterizing splenic tuberculosis. The patient has been in clinically disease free status for nearly 20 months after splenectomy.
authors.affiliation: Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, 712 Eonjuro, Seoul, Korea.
authors.forename: Jihe
authors.initials: J
authors.lastname: Lim
authors.forename: Jeong-Sik
authors.initials: JS
authors.lastname: Yu
authors.forename: Soon Won
authors.initials: SW
authors.lastname: Hong
authors.forename: Jae-Joon
authors.initials: JJ
authors.lastname: Chung
authors.forename: Joo Hee
authors.initials: JH
authors.lastname: Kim
authors.forename: Ki Whang
authors.initials: KW
authors.lastname: Kim
mesh_terms: D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009336:Necrosis; D013156:Splenectomy; D014400:Tuberculosis, Splenic / Q000473:pathology*